Otitis Externa

Otitis externa, sometimes referred to as "swimmer's ear", results from inflammation and irritation of the ear canal. This condition occurs secondarily to a bacterial infection of the ear canal. Swimmers have a particular problem with otitis externa, due to the constantly wet ear canal (prone to bacterial infection). The infection may also result from the placement of objects into the ear canal (pins, cotton swabs, etc.). Swimmer's ear is different from otitis media, where the canal is NORMAL but the eardrum is infected. Common symptoms of otitis externa include: ear pain that intensifies when tugging gently on the ear lobe. There is also point tenderness under the ear lobe (where the ear joins to the face). There may be a sticky, pus-like discharge out the ear, accompanied by decreased hearing on the affected side. Fever is unusual in cases of swimmer's ear and more typical of otitis media. Continued untreated otitis externa may result in spreading of the infection to the lymph nodes in the neck on the affected side. This results in pain down the neck, moving towards the chest. Evaluation includes a medical history and physical examination. The patient will be examined closely by the physician in order to omit the possibility of any foreign object having been retained in the ear canal (piece of a cotton swab). This examination is important since young children often place objects in the ear canal. Diagnosis is by physical examination. The findings include a swollen, red, and pus-coated ear canal. Treatment requires daily use of antibiotic ear drops (Cortisporin). Special care should be given to keeping the ear dry. Oral antibiotics are indicated in some cases with evidence of cervical lymphadenitis. Properly treated otitis externa will not result in any permanent ear damage.

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